1. Increased Aggression Is Associated With Higher Scores on Borderline Personality Features Scale in Bipolar Youth
Disclosures:
Kirti Saxena, MD : Grant Support from John S. Dunn Foundation
Christopher D. Verrico, PhD: Grant Support from The Department of Defense
R.P. Arvind, MD1,2, R.S. Kahlon, MD1,2 , P.A. Amin, MD1,2, C.D. Verrico, PhD1,3, A. Shah, MD1,2, M.Patel, MD1,2, L.L. Williams, DO1,2, K. Saxena, MD1,2
1Menninger Department of Psychiatry and Behavioral Sciences, Houston, TX, 2Psychiatry Service, Texas Children’s Hospital, Houston, TX, 3Department of Psychiatry, Michael E. DeBakey V.A. Medical Center, Houston, TX, 4 Psychology Section, Department of Pediatrics, Texas Children’s Hospital, Houston, TX, 5The Menninger Clinic, Houston, TX, 6Department of Psychology, University of Houston, Houston, TX, 7UT Harris County Psychiatric Center, Houston, TX
ID: P8-026
Objectives
Borderline personality disorder (BPD) is a serious, complex condition characterized by a pervasive pattern of instability and significant deficits in affective, cognitive, behavioral and interpersonal functioning with impulsive behaviors, verbal aggression, and depression.
Previous literature suggests that BPD adds significantly to the burden of BP illness and is associated with a more chronic and severe course and outcome.
To our knowledge, this is the first study to utilize the Borderline Personality Features Scale (BPFS) to evaluate whether borderline features and bipolar symptoms are related in children and adolescents.
Materials and Methods
24-item self-report Borderline Personality Features Scale (BPFS), as a battery of validated measures, was administered to obtain cross-sectional data from study participants and their respective primary caregiver.
Multivariable linear regression analyses examined associations between BPFS total score and various psychopathology-related predictor variables, while adjusting for age, race and primary BD diagnosis. The Buss Perry Aggression Questionnaire (BPAQ)
Quick Inventory of Depressive Symptomatology (QIDS) scale is a self- report measure of depression.
Conclusions
Some clinicians opine that early signs of personality disorders are apparent before the age of 18, and that identification of these maladaptive features in children and adolescents is important
This is clinically significant as specific psychotherapeutic interventions can be strategically targeted towards bipolar youth with comorbid borderline psychopathology.
Future longitudinal studies with larger sample sizes are required to assess the clinical characteristics of which bipolar youth will go on to develop borderline personality disorder. .
Results
BPFS child total score positively correlated with QIDS child total score (β=1.54, p=0.03).
BPFS Child total score positively correlated with Buss Perry Aggression Questionnaire (BPAQ) (β=0.35, p<0.01)
Positive correlation was observed between the BPFS parent negative relationship subscale and QIDS parent total score (β=0.48, p=0.05).
Furthermore, the BPFS parent negative relationship subscale positively correlated with QIDS parent irritability subscale (β=2.68, p=0.03).
Table 1: Demographics
CASES N 30
Gender
N of males 16
N of females 14
Age in years (mean ± SD)
12.95 ± 3.08
Race
N of White or Caucasian 25
N of Black or African 4
N of Other 1
Ethnicity
Non-Hispanic or Non-latino
Hispanic or Latino 5
Diagnosis
Bipolar 1 20
Bipolar 2 3
COBY Bipolar NOS 7
Mean Age(±SD)
13.3 ± 2.80
14.8 ± 0.290
12.8 ± 3.76
References
Yen, S., Fraizer, E. Hower, H., Weinstock, L.M.,
Topor, D.R., Hunt, J., & Strober, M. (2015). Borderline personality disorder in transition age youth with bipolar disorder. Acta Psychiatrica Scandinavica, 132(4),
2. Fonseka, T. M., Swampillai, B., Timmins, V., Scavone, A., Mitchell, R., Collinger, K. A., & Goldstein, B. I. (2015). Significance of borderline personality-spectrum symptoms among adolescents with bipolar disorder. Journal of Affective Disorders, 170,
3. Chang, B., Sharp, C., & Ha, C. (2011). The criterion validity of the Borderline Personality Features Scale for Children in an adolescent inpatient setting. Journal of Personality Disorders, 25(4), 492.
Materials and Methods
30 participants (7-17 years inclusive; mean age 12.95± 3.08) were enrolled from an outpatient specialty mood disorders clinic.
Participants met DSM-IV-TR criteria for BD-I and II, and the Course and Outcome of Bipolar Youth criteria for Bipolar Disorder-Not Otherwise Specified